Iowa officials move ahead with health plan

DES MOINES, Iowa (AP) -- A legislative compromise has been struck on low-income health care, but now Iowa starts the complicated process of putting the plan in place.

On Monday the state will kick off a series of public hearings to explain the proposed health care plan recently approved by the state House and Senate. The hearings are a step the state must go through to get federal approval.

But after the dramatic health care debate in the state Capitol throughout the legislative session, these hearings are likely to stir up little controversy. Only a handful of people have filed comments ahead of time, according to Roger Munns, a spokesman for the Iowa Department of Human Services.

State Sen. Jack Hatch, a Des Moines Democrat who advocated for Medicaid expansion, said he expected limited criticism.

"I think everybody is going to be supportive," Hatch said.

Under the plan — a compromise between lawmakers and Gov. Terry Branstad — Iowa will seek federal funding offered to states that expand Medicaid to provide benefits to low-income residents. Those with incomes up to 100 percent of the poverty line would go on a new state-run health plan with benefits similar to those offered to state workers. People with incomes from 101 to 138 percent of the poverty line would get private health plans on the new health care exchanges; those premiums would be paid for with the federal dollars.

This plan would largely cover poor people who don't currently qualify for Medicaid in Iowa, mostly childless adults. Estimates on how many Iowans would get insurance under this plan vary, going as high as 150,000. Many of those people are now on a state-run program that offers limited benefits.

The state must submit the application for federal approval by the end of the month, said Iowa Medicaid Director Jennifer Vermeer in an email. She said the state is still working on the application based on the approved plan.

The compromise came at the very end of the legislative session after months of conflict. Senate Democrats wanted to expand Medicaid as permitted under President Barack Obama's health care overhaul, but Gov. Terry Branstad and House Republicans favored an alternative plan that would have modified an existing program for poor Iowans.

Matthew Covington, an organizer with advocacy group Iowa Citizens for Community Improvement, said the group's member will attend the public hearings. The organization had lobbied for Medicaid expansion, but Covington said they are cautiously optimistic about the compromise.

"At face value it appears to have the elements of the original plan," Covington said. "But what we want to get out of the hearings, we want to know more of the details."

It's too soon to know if the state will get the federal backing, but a spokesman for the U.S. Department of Health and Human Services said the agency was supportive of state flexibility.

"HHS stands ready to work with Iowa to explore options that improve care and lower costs in the Medicaid program," said Fabien Levy in an emailed statement.

Another key issue for the state in the coming months will be how to promote this plan and let eligible residents know it is available.

Munns, the DHS spokesman, said in an email that the state is in the early stages of working on a plan to notify the public about the coming changes. Munns said that while the Legislature has provided some funding for the transition process, the state will likely "rely on providers and volunteer community partners to help get the message out, along with mailings and website materials."

Hatch said proper promotion is important for the effort to work.

"The governor has not outlined how he is going to inform, educate and enroll Iowans in these programs and that is a big black hole that we have to eliminate," Hatch said.